Because she could not be confirmed before the end of 2009, President Obama will have to resubmit her nomination (the White House says he plans to do this after the Senate returns from winter recess next week).
With Specter now in the 'yes' column, there are no obvious impediments to her confirmation. She will have to be re-approved by the Judiciary Committee, and Senate Majority Leader Harry Reid will have to bring the question of her confirmation to the floor. The question now is when and whether that will happen. Throughout much of last year, progressives grew furious with the White House and Senate leadership for not pursuing her confirmation in earnest. With the vote count now no longer in doubt, that anger will surely rise if Johnsen is not confirmed quickly.
Once a moderate Republican, Specter became a Democrat last spring, and has moved significantly to the left since Rep. Joe Sestak (D-PA) began a primary challenge shortly thereafter. Just this week, Sestak challenged his opponent to revisit his reported opposition to Johnsen, and it seems very much as if Specter was listening.